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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347005120
Report Date: 08/28/2026
Date Signed: 08/28/2026 07:07:15 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/13/2026 and conducted by Evaluator Reza Jamaly
COMPLAINT CONTROL NUMBER: 27-AS-20260413134818
FACILITY NAME:D & C ELDERLY HOMEFACILITY NUMBER:
347005120
ADMINISTRATOR:CORINA DRAGNEAFACILITY TYPE:
740
ADDRESS:9474 RANCH PARK WAYTELEPHONE:
(916) 686-8312
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: DATE:
08/28/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Corina DragneaTIME COMPLETED:
07:00 PM
ALLEGATION(S):
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Staff denied resident visitors
Staff denied resident access to hospice care
INVESTIGATION FINDINGS:
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On 8/28/2026 at 9:30 AM Licensing Program Analyst (LPA) Reza Jamaly arrived unannounced at the facility to deliver investigation findings regarding allegations noted above. LPA met with staff on duty and explained the purpose of the visit. Administrator (AD) Corina Dragnea was notified and arrived shortly after.
During the investigation, LPA conducted interviews with Reporting Party (RP), AD, Staff 1 (S1), Staff 2 (S2), Hospice Agency (D-ARH), Administrator (AD1) of Southern End Care Home, Hospice Nurse1 (HN1) and reviewed R1's record.

1. Staff denied resident visitors
LPA conducted interview with RP on 8/14/2026, LPA also reviewed emails RP sent to LPA Arvin on 4/13, 16, 20/2026.
Per RP, "on 4/8/2026 myself and administrator of the new home care I located to enroll R1, contacted the facility via business telephone listed, it was answered by S1, we coordinated with S1 that transport company will arrive to move R1 to new home care on Thursday 4/9/2026 at 9: AM.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Reza Jamaly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 27-AS-20260413134818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: D & C ELDERLY HOME
FACILITY NUMBER: 347005120
VISIT DATE: 08/28/2026
NARRATIVE
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They were denied entry to the facility, they returned two more times that day to attempt to remove R1 for safe transport to new facility, each time they were refused entry inside the facility".

LPA interviewed administrator of new facility (AD1), AD1 stated RP coordinated with me to check on R1 to make sure R1 is okay. When I got there, I got into the facility, talked to S2 and explained that I want to meet R1. I checked R1, everything looked good. LPA asked if AD1 knew R1 before, AD1 state no, I was told by RP to check R1 while RP was outside of the facility inside the car.  AD1 added that that on another occasion (doesn’t remember exact date), I witnessed RP called facility about R1 release. Also, RP texted me stating that RP called facility multiple time but they are not answering the phone.

LPA interviewed HN1 who was part of transportation team to move R1 on 4/11/2026, HN stated "when we got there, AD denied our entry and stated you cannot move R1 until a paper is signed by RP. Per HN1 a lot of communication happened between AD, police and RP, finally RP sent a document to police phone and police provided to AD and we moved R1. HN1 added that I signed an inventory sheet regarding R1 clothes, hygiene Items and other belongings that were placed inside a box. It was a rainy day; I could not find the chance to check one by one but moved that box to new home". HN1 confirmed that 4 attempt were done by American River Hospice to move R1.
LPA asked if other HN1 teammates were denied entry to the facility. HN1 stated; I don't exactly know about others but we had a meeting about this incident, another nurse also shared that they have been denied entry as well but I don't remember who shared this concern.

LPA interviewed AD regarding allegation above, AD stated no visitor been denied of entry to the facility. I was not at the facility when AD1 came to the facility, an individual later identified as AD1 entered the facility on 4/8/2026 without prior notice and identified self as R1's friend visiting from out of state, staff contacted me, after communication with AD1, visitation was permitted.
On 8/28/2026 LPA Jamaly interviewed with S1, S1 stated no body coordinated about R1 pick up on Apr 8 and 9, I just got a call on Friday Apr 10 and told them that you should contact with AD about R1 release, other than that I did not have any interaction with police or any other person about R1.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Reza Jamaly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 27-AS-20260413134818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: D & C ELDERLY HOME
FACILITY NUMBER: 347005120
VISIT DATE: 08/28/2026
NARRATIVE
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Page 3

2. Staff denied resident access to hospice care

LPA interviewed RP on 8/14/2026, Per RP, American River Hospice ordered the transport 4 separate times, also tried to contact AD several times but AD did not answer the phone. RP added that police got involved on April 9, 10, and 11. I called AD on 4/11/2026 at 9:00 am and asked the reason for not releasing R1, AD asked me to write a statement taking all responsibilities of R1 and sign it. Finally, I signed a statement as requested, finally R1 released.

8/28/2026 LPA Jamaly interviewed Director of American River Hospice (D-ARH) where R1 recently been enrolled to receive hospice services. D-AHR stated that RP enrolled R1 on 4/10/2026, RP signed all paper works, we arranged to move R1 from current facility to new one on 4/10/2026 but AD did not allow us to move R1, based on RP's request, we arranged transportation with two drivers and one nurse again on 4/11/2026 but AD refused again, until police got involved. There were hours of communication between police, RP, AD. LPA asked D-ARH if AD knew that R1 is under your services? D-ARH stated yes that our nurse completed evaluation at this facility, and we told them that R1 is under our services.

LPA interviewed AD and asked the reason for the refusal to release R1, AD stated, how I can release a bed bound and non-verbal resident to strangers who I never see in my life. RP just sent drivers and a nurse who I never saw before. I asked police, drivers and nurse if they could take all future responsibilities and sign a paper in this regard, but they all refused to do so. I just needed RP to write a statement taking the responsibilities and sign it. RP told me, I don't know how to write and what to write, then I provided a template and sent it to RP. Finally, RP sent the required statement and I released it. R1 on 4/11/2026.

LPA asked if AD knew that R1 is under new hospice services, AD stated yes, a nurse came on 4/10/26 and evaluated R1 but nobody told me that contract was signed between RP and new hospice agency. LPA Jamaly interviewed AD, if any direct call has been placed to RP during 4/8/2026- 4/11/2026, AD stated that no call is made to RP within these three days despite all challenge, finally on 4/11/2026 RP called AD and agreed to sign a paper.

LAP observed an email was sent by AD on Apr 10, 26 at 6:00 AM to RP asking to provide details of person who would be responsible for R1 release, such as name, relationship, placement name and authorization of release from RP.


SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Reza Jamaly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20260413134818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: D & C ELDERLY HOME
FACILITY NUMBER: 347005120
VISIT DATE: 08/28/2026
NARRATIVE
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LPA Jamaly reviewed POA letter signed by RP in Sep 2012. Per this document, RP has full power and authority to do and undertake all acts on behalf of R1 including the right to make financial contacts, to initiate, defend, commence or settle legal actions on R1's behalf.

LPA reviewed 30-day’s Notice of Relocation effective 3/25/2026 to 4/23/2026. Per this notice, R1 considered bedridden, and facility is not approved to care for bedridden residents in the room currently occupied by R1.

Based on interview conducted, document reviewed, facility failed to allow hospice agency entry to facility and facility failed to release R1 as requested by power of attorney despite issuing 30 days eviction notice. So, this allegation is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted with AD Corina Dragnea and a copy of this LIC 9099, LIC 9099-D page and appeal rights provided to facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Reza Jamaly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20260413134818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: D & C ELDERLY HOME
FACILITY NUMBER: 347005120
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2026
Section Cited
CCR
87468.1(a)(11)
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87468.1(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights...To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately ..
This requirement was not met as evidenced by:
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Administor/Licensee will review resident's personal rights and facility visitation policy and submit a sign statement that policy reviewed.
The Administrator will provide training to all direct-care staff regarding residents' visitation rights and submit a copy of the staff training that include training title, trainees signature and date of trainig by due date.
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Based on interview and record review conducted by LPA Jamaly, administrator did not ensure visitors get acces to the facility to check on resident who is on end of life as requested by resident's family member which poses an immediate health and safety risks to resident in care
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Type B
09/15/2026
Section Cited
CCR
87468.1(a)(16)
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87468.1(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:
(18) To move from the facility.
This requirement was not met as evidenced by:
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Administrator/Licensee will review eviction procedure and resident's personal rights and send a signed statement that relavent regulations are reviewed.
The Administrator will provide training to all staff regarding residents' rights related to leaving or moving from the facility and send proof of training completion that includes training title, trainees signature and date of trainig by due date.
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Based on interview and record review conducted by LPA Jamaly, administrator did not allow residents family to transfer resident to another facility even after issuance of relocation (eviction) by the facility, which poses an immediate health and safety risks to resident in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Reza Jamaly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5